Thoracic Surgery Department

Thoracic Surgery Department, founded in 1973, is one of the earliest thoracic cancer surgery departments established in China. With the aim of standardized comprehensive diagnosis and treatment and the orientation of individualized precise diagnosis and treatment, the discipline actively promotes the construction of refined sub-specialty. At present, it has three sub-specialties: lung cancer surgery, esophageal cancer surgery, minimally invasive and mediastinal surgery, and thoracic surgery intensive care units. It has 130 beds and 10 ICU beds. There are 29 practicing physicians and 12 full-time researchers in the department of thoracic surgery. Among them, there are 4 postdoctoral scholars and 13 PhDs. Nearly one third of them have overseas study experience. There is 1 in the project of "Excellent Medical Talents in Jiangsu Province ", 1 in the project of "Innovative Team and Leading Talents in Jiangsu Province", 1 in the project of "Key Medical Talents in Jiangsu Province", 4 in the project of "333 High-Level Talents in Jiangsu Province”, 4 in the project of "Young Medical Talents in Jiangsu Province" and 12 in the project of "Six Peak Talents in Jiangsu Province”.

In 2011, Thoracic Surgery Department of Jiangsu Cancer Hospital was selected as the first batch of national key clinical specialty construction project units (the only one in six provinces in East China). In recent years, under the leadership of Professor Xu Lin and Professor Zhang Qin, the department has developed rapidly, and became one of the largest thoracic cancer surgery departments in six provinces of East China excellent in both clinical and scientific research. It has formed its own characteristics and advantages in "surgical treatment of complex lung cancer, tracheal and mediastinal tumors, minimally invasive surgical treatment of lung cancer and esophageal cancer, comprehensive diagnosis and treatment of esophageal anastomotic fistula and one-stop minimally invasive and accurate diagnosis platform, which is first-class in China and even advanced in the world. Thoracic Surgery Department has a first-class thoracic endoscopy room in China. It integrates the first domestic 3D thoracoscope with the first-class minimally invasive diagnostic and therapeutic equipment such as EBUS, fluorescent bronchoscope and TV mediastinoscopy, and establishes a platform for minimally invasive and accurate diagnosis and staging of lung cancer, which significantly improves the level of accurate diagnosis and staging of lung cancer. Thoracic Surgery Department routinely carries out lung cancer, esophageal cancer (including cardiac cancer), tracheal cancer, mediastinal cancer, chest wall cancer and other types of thoracic cancer surgery. Based on the experience accumulated in tens of thousands of surgical cases over the past decades, Thoracic Surgery Department has formed its own characteristics and advantages in difficult thoracic cancer surgery. In the field of minimally invasive treatment of early lung cancer and enlarged resection of locally advanced lung cancer, more than ten new surgical methods, new methods and new instruments have been innovated independently, and a series of international puzzles in the treatment of lung cancer have been overcome. Thoracoscopic radical resection of lung cancer with pulmonary vascular occlusion was pioneered in the world, which solved the worldwide problem of massive hemorrhage in thoracoscopic lung cancer resection, and reasonably expanded the surgical indications. The first thoracoscopic secondary carina plasty in the world was successfully completed by using the self-innovative "curved needle straight suture" technique. Pulmonary transplantation and cardiovascular surgery are applied to locally advanced lung cancer involving cardiac vessels and carina. High-risk surgery for locally advanced lung cancer, using autologous lung transplantation, combined resection and reconstruction of lung and multiple organs (tracheal carina, superior vena cava resection and reconstruction), partial resection and anastomosis of pulmonary cone, partial left atrial resection under cardiopulmonary bypass, breaks through the traditional surgical taboos and fills in many domestic gaps. The Thoracic surgery Department of Jiangsu Cancer Hospital is one of the centers with the largest number of cases and the highest difficulty at home and abroad. With the great effort of the department, the treatment effect is remarkable. Some patients with "survival period not exceeding 3 months" have achieved long-term survival.

In the field of surgical treatment of esophageal cancer, we take the lead in developing "non-thoracotomy esophagectomy" for the treatment of early esophageal and cardiac cancer in China, and developed cervical stapler and esophagogastric stapler by ourselves, and reconstructed esophagogastric tract by colon. In recent years, new technologies have been continuously innovated and introduced to explore the surgical treatment of esophageal cancer from the aspects of curative effect, quality of life after operation and safety. Three-field esophageal cancer dissection, total mediastinal lymph node dissection under left thoracic approach, thoracoscopic and laparoscopic esophageal cancer radical resection and esophageoscopic radical operation under pneumatic mediastinoscopy have been carried out. In the field of surgery for complex mediastinal and tracheal tumors, we have rich experience in the difficult surgical treatment of complex mediastinal and tracheal tumors. For patients with thoracic tumors invading the superior vena cava, the tumors and the superior vena cava were successfully resected and replaced with artificial blood vessels. Resection and reconstruction of complex tracheal tumors such as subglottic tracheal cancer and carina cancer were performed. High survival rate and good quality of life have been achieved, and the treatment effect ranked in the international advanced level. In the treatment of complications after thoracic cancer surgery, self-innovative "new three-tube therapy" for anastomotic fistula after esophageal cancer surgery has significantly improved the cure rate of anastomotic fistula. For refractory bronchopleural fistula, the technique of precise occlusion of greater omentum under the combination of thoracoscopy and fiberoptic bronchoscope was first developed to overcome the difficult problem of refractory bronchopleural fistula. It is the first reported in China that combining thoracoscopy and bronchoscopy assisting pectoralis major muscle turnover and omentum packing technique was used to treat refractory bronchial stump fistula. In the field of comprehensive treatment, multi-disciplinary clinical and case discussions of thoracic tumors involving thoracic surgery, chemotherapy, radiotherapy, imaging and pathology were carried out. A multi-disciplinary outpatient clinic for small pulmonary nodules and a multi-disciplinary comprehensive diagnosis and treatment system for thoracic tumors have been established. We should standardize the formulation of treatment plans, implement the basic principles of individualization, and treat patients scientifically and reasonably. Each year, more than 3000 patients and 2000 surgical patients were admitted to the department. As the deputy head of lung cancer group of the Chinese Society of Thoracic and Cardiovascular Surgery, Thoracic Surgery Department participated in the formulation of "Clinical Pathway of Thoracic Surgery", "Standards for Diagnosis and Treatment of Primary Lung Cancer" and "Training Plan for Thoracic Surgeons and Thoracoscopic Physicians" by the National Health and Family Planning Commission.

Thoracic Surgery Department is one of the few specialized hospital training bases responsible for standardized resident training tasks. The department undertakes a heavy and orderly clinical teaching task and at the same time attaches great importance to transformational basic research in scientific research. In 2013, “Jiangsu Key Laboratory of Molecular Biology and Translational Medicine of Malignant Tumors” was established with the approval of Jiangsu Provincial People's Government (Independently Compiled). Depending on the two platforms of "Jiangsu Key Laboratory of Molecular Biology and Translational Medicine of Malignant Tumors" and "Jiangsu Biological Sample Bank of Major Diseases", Thoracic Surgery Department cooperates closely with universities and enterprises within medical industry. Based on the clinical samples of patients with thoracic cancer, from the perspectives of genetic variation of susceptible genes, protein and expression of non-coding RNA, we have found and identified innovative biomarkers and potential new targets related to the occurrence, development, invasion and metastasis of lung cancer, part of which has realized  technology transformation of clinical innovation. A total of 104 SCI papers have been published; 17 national-level projects have been awarded, 21 provincial and ministerial-level projects have been awarded, with a total research expenditure of more than 30 million yuan; 14 national patents have been awarded; 16 awards have been awarded, including 1second-class award for National Scientific and Technological progress (2012), 2 first-class awards for Science and Technology in Jiangsu Province (2012, 2015); more than 10 national and provincial Science and Technology Awards, including 1 special prize for the Introduction of New Medical Technology in Jiangsu Province (2014). Thoracic Surgery Department is editor-in-chief and compiler-in-chief of 13 monographs and postgraduate textbooks; more than 50 postgraduates were trained. Thoracic Surgery Department ranked 7th in China in 2017, and was listed in the Top 4 of East China Hospital Specialist List of Fudan University (the Top 3 are hospitals from Shanghai).

Academic leader, Professor Xu Lin, has overcome many worldwide technical problems in minimally invasive surgery for lung cancer through innovating a series of key technologies of minimally invasive lung cancer, such as "thoracoscopic hemorrhagic pneumonectomy" and "thoracoscopic omni-directional tracheal anastomosis (Xu's Needle Method)". In the surgical treatment of complex thoracic tumors, cardiovascular surgery and lung transplantation were applied to the surgical treatment of complex lung cancer. More than ten new surgical methods for resection and reconstruction of complex lung and tracheal tumors were initiated, which broke through many forbidden areas for surgical treatment of complex lung cancer and changed the traditional treatment mode of complex lung cancer. Academic leader, Professor Zhang Qin, led the establishment of standardized diagnosis and treatment system of thoracic tumors in Jiangsu Province. Through the introduction, digestion and absorption of international advanced diagnostic and therapeutic technologies, after more than 10 years of hard tackling key problems, the standardized and precise diagnostic and therapeutic features of thoracic tumors based on Jiangsu have been established. Especially in the precise treatment of esophageal and cardiac cancer, the minimally invasive treatment of total endoscopy operation is in the leading level in China.